Serum Amylase Levels Research Articles

Acute Pancreatitis after Lumbar Spine Surgery: A Case Report

Acute pancreatitis is a rare but potentially life-threatening complication that typically occurs after various abdominal procedures, but it is extremely uncommon following spinal surgery. This case study describes a 38-year-old male martial arts champion who developed acute pancreatitis after undergoing lumbar laminectomy and Transforaminal Lumbar Interbody Fusion (TLIF) surgery for chronic lower back pain and bilateral radiculopathy in both legs. Despite the absence of typical risk factors, such as alcohol consumption or a history of pancreatitis, the patient developed abdominal pain, nausea, and vomiting on the second postoperative day, along with elevated serum amylase levels. These clinical findings raised suspicion for acute pancreatitis, which was subsequently confirmed through diagnostic imaging. Prompt treatment led to the resolution of symptoms and normalization of pancreatic enzyme levels. This case underscores the importance of recognizing and managing uncommon complications following spinal surgery, highlighting the necessity for a comprehensive, multidisciplinary approach to ensure optimal patient care.

Risk factors of asparaginase-associated pancreatitis in children with acute lymphoblastic leukaemia

Background: Acute lymphoblastic leukaemia (ALL) is the top childhood cancer, with survival rates of 80–85%. Attention now focuses on treatment complications. Pancreatitis, linked to Asparaginase in ALL therapy, remains poorly understood despite its recognition. The main objective of the study was to identify the risk factors of pancreatitis in children with acute lymphoblastic leukemia receiving L-Asparaginase during induction chemotherapy. Methods: A prospective observational study was conducted at BSMMU's Paediatric Haematology and Oncology Department from March 2018 to February 2019. Newly diagnosed ALL cases in children aged 1 to 17.9 years were included, excluding those <1 or >18 years, with prior pancreatitis, or relapsed cases. Informed consent was obtained from parents/legal guardians. Diagnosis relied on clinical, CBC, bone marrow and immunophenotyping. Induction chemotherapy followed the UK ALL 2003 protocol for 35 days, with regular follow-ups monitoring abdominal symptoms and laboratory markers. USG of the abdomen was performed if pancreatitis symptoms or elevated serum amylase/lipase occurred post-L-asparaginase administration. Results: Among 80 patients, pancreatitis affected 3 (3.8%) after the 2nd, 3rd and 7th doses of L-asparaginase, independent of individual or cumulative dosing, induction phase or concomitant medications. Age, sex, initial WBC count, ALL lineage, treatment regimen and CNS status were not statistically linked to pancreatitis incidence. Clinical manifestations included abdominal pain, tenderness, nausea, vomiting and fever, alongside elevated serum amylase and lipase levels, supported by consistent ultrasonographic findings. Despite these symptoms, no pancreatitis-related mortalities were observed, however, overall mortality during induction therapy reached 20%, unrelated to pancreatic complications. Conclusions: In this study no significant risk factor could be identified for developing pancreatitis in ALL patients treated with asparaginase. Further studies with large sample size are required to predict who will develop pancreatic toxicity from asparaginase.

CIP2A inhibitors TD52 and Ethoxysanguinarine promote macrophage autophagy and alleviates acute pancreatitis by modulating the AKT-mTOR pathway

BackgroundAcute pancreatitis (AP) is a prevalent and serious condition within the digestive system, with approximately 20 % to 30 % of cases advancing to severe acute pancreatitis (SAP). During the initial phases of SAP, macrophages are activated in response to the substantial amounts of acinar cell contents and damage-associated molecular patterns (DAMPs) resulting from acinar cell destruction. Subsequently, activated macrophages release a significant array of pro-inflammatory factors that exacerbate the progression of SAP. Cancerous inhibitor of protein phosphatase 2A (CIP2A) is an oncogenic protein that is intimately linked to immune regulation. While the role of CIP2A in T-cell-mediated specific immune responses has been reported, its function and mechanism in macrophages, a component of non-specific immunity, have not been widely studied. This research fills this knowledge gap by elucidating the critical role of CIP2A in regulating macrophage autophagy and inflammation. This finding not only expands our understanding of CIP2A in immune modulation but also provides a new scientific basis and potential application prospects for targeting CIP2A in the treatment of AP. MethodsWe established AP using a combination of palmitoleic acid with anhydrous ethanol or using caerulein alone. The effects of TD52 and Ethoxysanguinarine (Etho) on SAP were evaluated through serological, histopathological, and tissue inflammation observations. The effect of TD52 on macrophage activation in vitro was examined using primary macrophages (PMs) and RAW264.7 cells. ResultsWe found that TD52 and Etho inhibit CIP2A expression while reducing the levels of serum amylase, lipase, and inflammatory cytokines, thereby alleviating the pathological symptoms of SAP. Additionally, TD52 could reduce the infiltration of macrophages into pancreatic tissue. Therefore, we established a model of macrophage inflammatory response mimicking the pathophysiological process of AP and detected changes in inflammation, apoptosis, and autophagy through pre-treatment of macrophages with TD52. The results show that inhibiting CIP2A expression decreases the release of inflammatory cytokines and reduces apoptosis in macrophages. Further exploration revealed that TD52 promoted macrophage autophagy regulation and inhibited the AKT-mTOR pathway to modulate macrophage activation. ConclusionIn summary, our findings indicate that TD52 and Etho can alleviate the severity of SAP. TD52 can block the AKT-mTOR pathway to promote macrophage autophagy, thereby improving SAP. Thus, CIP2A may serve as one of the molecular targets in SAP, highlighting its potential as a therapeutic option.

HPB SO57 - Imaging in Acute Pancreatitis: Are We Getting It Right?

Abstract Background Guidelines indicate that routine use of imaging is unwarranted in patients with acute uncomplicated pancreatitis presenting with abdominal pain and increased serum amylase or lipase levels without signs of severe disease. Moreover, early CT scans may fail to accurately reflect disease severity and provide no diagnostic advantage. Method We performed a retrospective clinical audit at a district general hospital in the United Kingdom to find out the current practice regarding the use of imaging in patients presenting with acute pancreatitis. The patients were studied from January 2023 to March 2023 for the 1st cycle, and from April 2024 to May 2024 for the 2nd cycle. The list was identified by the clinical audit department – adult patients who presented to the A&E with symptoms of acute pancreatitis were included. Results Between January - March 2023, 44 patients presented to A&E with symptoms of acute pancreatitis. Of these, 25 (56%) had a CT-scan within 72-hours, with 80% showing evidence of acute pancreatitis —1 with pancreatic necrosis, 7 with intra-peritoneal fluid, & 5 with peri-pancreatic fat-stranding. The study revealed poor compliance with standards, prompting efforts to raise awareness. Findings were shared at the departmental audit meeting, & posters were displayed in A&E and GeneralSurgery departments. In the 2nd-cycle (April-May 2024), 32 patients presented, with 14 (53%) having a CT-scan within 72-hours & all had serum amylase levels checked, with 11 within normal limits. Conclusion This closed-loop clinical audit demonstrated that with appropriate measures and improved awareness of current guidelines, there can be increased compliance to the guidelines by the clinicians. This, in turn, reduces the risk of radiation exposure to patients and optimizes the use of CT scans.

Boron neutron capture therapy for cutaneous angiosarcoma and malignant melanoma: First in-human phase I clinical trial

Background and purposeDefinitive radiotherapy for patients with scalp angiosarcoma has a poor prognosis, often resulting in severe skin adverse events. Additionally, malignant melanoma is known for its radioresistant nature. Boron neutron capture therapy (BNCT) may address these challenges due to the high uptake capacity of boron drugs in these cancer types. We aimed to determine the treatment dose for BNCT and evaluate the incidence of acute adverse events AEs following BNCT in patients with primary or recurrent angiosarcoma/malignant melanoma of the skin. Materials and methodsThis was a single-center, non-randomized clinical trial with a three-step dose escalation plan, involving maximum skin doses of 12, 15, and 18 Gy-Eq following a 3 + 3 design. The patients underwent BNCT between November 2019 and April 2022. The primary endpoint was to evaluate the incidence of acute adverse events. ResultsTen patients (scalp angiosarcomanine, forefinger malignant melanoma: one) were included. The median target lesion size was 46.5 (range: 20–145) mm. A transient asymptomatic increase in serum amylase level was the only grade 3 adverse event. The best overall response rate within 180 days was 70 % (median tumor shrinkage rate: 77.5 % [4.9–100 %]). ConclusionsBNCT with a dose of 18 Gy-Eq is a feasible treatment option, demonstrating a favorable safety profile and a high response rate in patients with primary or recurrent angiosarcoma or malignant melanoma of the skin.

Preoperative hyperamylasemia relates to renal dysfunction and hyperamylasemia in cardiac surgery: an observational study.

The role of preoperative hyperamylasemia in the perioperative enzyme levels in patients undergoing cardiac surgery is unclear. The primary outcome of this observational clinical study was to determine whether patients with preoperative hyperamylasemia undergoing on-pump cardiac surgery document an increase in serum amylase levels perioperatively compared with patients with normal serum amylase levels preoperatively. This prospective study evaluated serum total, pancreatic, and salivary amylase levels, estimated glomerular filtration rate (eGFR), and serum creatinine before the operation at postoperative days (POD) 1, 2, 3, and 7. We also followed up on any perioperative symptoms, including abdominal pain and lower ear or jaw swelling. We preoperatively had 157 patients with normal amylase levels (Normal group) and 45 with hyperamylasemia (Hyperamylasemia group). The Hyperamylasemia group demonstrated continuously lower eGFR and higher creatinine values at the preoperative time, postoperative days 1, 2, 3, and 7, compared with the Normal group. The Hyperamylasemia group showed higher serum total, pancreatic, and salivary amylase levels at preoperative (total 70 [55-90] [Normal] vs. 142 [107 to 162] [Hyperamylasemia] IU/L, median [25-75th percentile], P < 0.001) and postoperative periods compared with the Normal group. The relationship between renal dysfunction and serum amylase levels in all patients was significant in the preoperative, but not postoperative, periods. We noted no patients demonstrating clinical symptoms. Preoperative hyperamylasemia in patients undergoing on-pump cardiac surgery was associated with renal dysfunction without needing hemodialysis. However, whether the relation affects postoperative serum amylase levels is inconclusive.

ASSESSMENT OF LABORATORY PARAMETERS IN PATIENTS WITH ACUTE PANCREATITIS OF VARIOUS ETIOLOGIES

Summary. Abstract. Acute pancreatitis remains one of the most prevalent diseases worldwide. Alcoholic and biliary factors are considered the most common causes of AP. The aim of the study was to investigate the laboratory characteristics of patients with AP, taking into account the etiological variant of the disease. Materials and methods: the study is retrospective. Medical records of 677 patients hospitalized for AP in two medical institutions from 2017 to 2022 were analyzed: Vinnytsia сity сlinical emergency hospital and Vinnytsia regional clinical hospital named after M.I. Pyrogov. For further study of laboratory parameters of all AP patients, they were divided into four groups depending on the etiology: alimentary, biliary, alcoholic, and postoperative. The laboratory data obtained within the first 24 hours of hospitalization were analyzed. Results. Intergroup differences in the distribution of laboratory parameters were observed among different etiological variants of AP. Some of them showed only significant intergroup deviations within reference values, while some also deviated from the norm. Specifically, for alimentary AP, there was a significant increase in creatinine levels compared to other groups. For biliary AP, there was a significant increase in leukocyte count, neutrophil-to-lymphocyte ratio, total bilirubin, blood glucose levels, and a significant decrease in lymphocyte count. For postoperative AP, there was a significantly the lowest level of increase of serum amylase levels, significant elevation in ALT and AST levels, and significant increase in stabs neutrophils and ESR compared to other groups. Conclusions. Analysis of blood and urine laboratory parameters in patients with AP allowed to identify intergroup differences in their distribution for different etiological variants of AP without deviation from the norm, as well as deviations from reference values. The obtained data should be taken into account at the stage of hospitalization and the beginning of inpatient treatment of patients with AP for further stratification and development of individualized diagnostic and therapeutic programs.

Vitamin B12 protects necrosis of acinar cells in pancreatic tissues with acute pancreatitis.

Pharmacological agents regarding the most optimal treatments of acute pancreatitis remain. One-carbon metabolism nutrients as therapeutic agents in many diseases might be involved in acute pancreatitis. The roles are acquired exploration in acute pancreatitis. We utilized Mendelian randomization to assess the causal impact of folate, homocysteine, and vitamin B12 (VB12) on acute pancreatitis. Wild-type and corresponding genetically modified mouse models were used to verify the genetic correlating findings. A negative association between genetically predicted serum VB12 levels and risks of acute pancreatitis was identified in human population. The transcobalamin receptor (TCblR)/CD320 gene ablation that decreased cellular VB12 uptake and ATP production in pancreatic tissues promoted necrosis, resulting in much severe pathological changes of induced acute pancreatitis in mice. VB12 pretreatment and posttreatment dramatically increased ATP levels in pancreatic tissues and reduced the necrosis, then the elevated levels of amylase in serum, the levels of CK-19, the activity of trypsin, and T lymphocyte infiltration in pancreatic tissues, prevented the pancreatic gross loss and ameliorated histopathological changes of mouse pancreases with induced acute pancreatitis. The results reveal that VB12 is potential as a therapeutic agent to inhibit tissue injuries and adaptive inflammatory responses in the pancreas in patients with acute pancreatitis.

Multifocal Hemorrhagic Choriocarcinoma With Diffuse Pancreatic FDG Uptake on 18F-FDG PET/CT.

Choriocarcinoma is a rare and highly malignant trophoblastic tumor. We present a case involving a 30-year-old woman with abdominal pain, hemoptysis, and elevated serum amylase levels. Initial clinical suspicion included acute pancreatitis. Noncontrast and contrast-enhanced CT revealed hemorrhagic and hypervascular lesions in the lungs, pancreas, liver, and kidneys. 18F-FDG PET/CT showed diffuse pancreatic enlargement with increased FDG uptake (SUVmax, 5.3), consistent with malignancy. Histopathology confirmed choriocarcinoma with elevated HCG levels. Following chemotherapy, HCG levels declined, indicating a positive therapeutic response. 18F-FDG PET/CT effectively detected choriocarcinoma and assessed its systemic involvement.

The Significance of Diffusion-Weighted Imaging and Apparent Diffusion Coefficient in the Diagnosis of Early Acute Interstitial Edematous Pancreatitis.

The study assessed the diagnostic value of diffusion-weighted imaging (DWI) and mean apparent diffusion coefficient (ADC) in early acute interstitial edematous pancreatitis (AIEP). Fifty-six AIEP patients and 60 healthy controls underwent an upper abdominal magnetic resonance (MR) examination. The pancreas diameter and ADC values were measured and analyzed across age and gender groups. Results showed that the pancreas diameter varied with sex and age, with smaller diameters in females and the elderly. Mean ADC values were not significantly affected by age or sex. Signal changes were observed in AIEP patients' images, with DWI showing a higher positive rate than T1WI and T2WI. Comparing the control and AIEP groups, the pancreas diameter was significantly larger in AIEP patients, particularly the pancreatic tail in males. ADC values were significantly lower in AIEP patients, and the difference was more pronounced at b=800 s/mm² compared to b=500 s/mm². Mean ADC exhibited good diagnostic potential for early AIEP, with higher sensitivity and specificity values than serum amylase levels. The area under the receiver operating characteristic (ROC) curve (AUC) indicated that the diagnostic value was better at b=800 s/mm² than at b=500 s/mm². In conclusion, the study found that normal pancreas diameter is influenced by sex and age, with smaller diameters in females and the elderly. Mean ADC values were not affected by these factors. Early AIEP could not be diagnosed solely based on pancreas diameter changes. DWI combined with Mean ADC demonstrated high diagnostic value for early AIEP.

A-125 Difference Between the Results of Vitros® Dry Biochemistry and Wet Biochemistry with Kinetic Method in Diagnosing the Comorbidity of Lung Adenocarcinoma and Aacroamylasemia: Case Report

Abstract Background Amylase (AMY) is a biomarker that comes mainly from the pancreas and salivary glands. Macroamylasemia is a condition often accompanied by malignant tumors and clinical features that include: (i) recurrent abdominal pain, no abnormality in the salivary glands, serum amylase (AMY) level ≥2 to 3 times higher than the normal value and poor patient response to treatments for pancreatitis; (ii) normal serum creatinine and urea levels, increased serum AMY level, and urine AMY level within the normal range or slightly lower. Because macroamylasemia may cause abnormally increased serum AMY levels for a long period of time, misdiagnosis of pancreatitis and delayed diagnosis/treatment of the disease may occur. We report a case of lung adenocarcinoma with macroamylasemia that was co-diagnosed using wet chemistry with kinetic method and dry chemistry to measure AMY. Methods A 47-year-old male patient was previously diagnosed with “acute pancreatitis and lung infection” after initial admission to a local hospital with paroxysmal cough and abdominal pain without obvious cause. To further diagnose the patient, we determined the blood AMY level by using the wet chemistry with kinetic method and the Vitros® dry chemistry test, in addition to conducting a physical exam, abdominal and chest computed tomography (CT), and other lab tests. Two methods, calculation of amylase/creatinine clearance ratio (Cam/Ccr ratio) and protein precipitation by polyethylene glycol (PEG), were also performed to validate assumed interference by serum macroamylase (MAMS) in the wet chemistry method compared to the dry chemistry method, which has technology to capture large molecules and minimize the impact of interferents. MAMS is a high-molecular-weight AMY complex that is synthesized by normal serum AMY bound with macromolecular substances (eg, immunoglobulins and carbohydrates). Results The final diagnosis was a stage IIB cT3N0M0 adenocarcinoma of the upper lobe of the right lung and macroamylasemia. Symptoms and radiologic findings were atypical in terms of pancreatitis. Serum AMY was 2,178U/L when measured with the wet chemistry with kinetic method. When the specimen was re-tested with Vitros dry chemistry, the AMY level was 369 U/L. After precipitation with 25% PEG 6000 solution, the blood AMY level from wet chemistry decreased from 2395.1 U/L to 246.7 U/L, yielding a precipitation rate of 89.7%. Cam/Ccr ratio was calculated as 0.23% (&amp;lt;1%). The calculated PEG precipitation rate and Cam/Ccr ratio from this study were consistent with the ranges considered for macroamylasemia, which are ≥73% and Cam/Ccr ratio &amp;lt;1%, respectively. Conclusions High serum AMY levels do not necessarily indicate pancreatitis or parotitis; wet chemistry results can be impacted by the presence of serum macroamylase. Instead of relying solely on blood AMY in diagnosing acute pancreatitis, clinicians should also consider the correlations of blood AMY with urine AMY and blood lipase. In patients with prolonged blood AMY elevation but normal lipase and urine AMY, re-testing of AMY with a more interference-resistant methodology (e.g. Vitros dry chemistry) may be requested. Accordingly, Cam/Ccr ratio calculation and PEG precipitation can be performed to validate the diagnosis of macroamylasemia.

The role of ischaemia-modified albumin in the prognosis of acute pancreatitis and its correlation with the NF-κB-mediated inflammatory response.

To investigate the correlation between the serum levels of ischaemia-modified albumin (IMA) and disease severity in rats with acute pancreatitis (AP). A rat AP model was established and blood samples from each group were analysed at different time points. After the experiment, the pancreatic tissues of the rats were collected for pathological examination and the measurement of protein levels of NF-κB and NF-κB p65. Serum levels of amylase (α-AMY), tumour necrosis factor-α (TNF-α), interleukin (IL)-6 and IL-8 were also compared between groups of rats. The serum IMA concentration in the severe acute pancreatitis (SAP) group was greater than that in the mild acute pancreatitis (MAP) group. The levels of the NF-κB and NF-κB p65 proteins were increased in the MAP and SAP groups in a time-dependent manner. α-AMY, TNF-α and IL-6 were increased at all time points in the MAP and SAP groups. The increases were greatest at 24 h in the SAP group. In terms of pathological changes in the pancreas, renal and lung tissues, the damage in the SAP group was more obvious than that in the MAP group. Serum IMA level was associated with inflammatory markers and NF-κB p65 in rats with AP.

A Study on Urinary Amylase and Serum Amylase in Diagnosing Acute Pancreatitis.

Acute pancreatitis is a prevalent condition often characterized by abdominal pain, yet its early diagnosis remains challenging due to the limitations of current diagnostic tests, particularly serum amylase. This study aimed to evaluate the effectiveness of urinary amylase compared to serum amylase in diagnosing acute pancreatitis, with a focus on its sensitivity and prolonged detection capabilities. Conducted over two years at a tertiary care hospital, Dr. D. Y. Patil Medical College,Hospital and Research Centre in Pune, India, the study included 60 patients suspected of acute pancreatitis based on clinical and radiological criteria. Participants aged 20 to 60 were included, while those with chronic pancreatitis, pancreatic malignancies, or significant comorbidities were excluded. Serum and urinary amylase levels were measured, and statistical analysis was performed using MS Excel and IBM SPSS version 27(IBM Corp., Armonk, NY). The study population had a mean age of 37.90 years, predominantly that is 50 (83.3%) were male. The median serum amylase level was 311 U/L, while urinary amylase levels averaged 501 U/L. Significant findings included urinary amylase levels being significantly higher in females compared to males. Diagnostic imaging revealed various pancreatic conditions, including acute pancreatitis with complications. Urinary amylase proves to be a valuable diagnostic marker for acute pancreatitis, offering several advantages over traditional serum amylase measurements. Integrating urinary amylase measurement into clinical practice can enhance diagnostic accuracy and provide a more comprehensive approach to diagnosing acute pancreatitis.

Atypical Mumps; are We Heading Towards an Outbreak?

Mumps, caused by the mumps virus, is a contagious disease primarily affecting children and young adults. While typically presenting with salivary gland swelling and systemic symptoms, mumps can lead to various complications including SNHL, orchitis/ oophoritis, aseptic meningitis. Recent observations suggest atypical features in mumps cases, raising concerns of a potential outbreak in India. To discuss the etiopathogenesis and clinical presentation in cases of atypical mumps with increasing number of cases, a prospective multicentric study was conducted across five major centers - SMS Medical College Jaipur, RDBP Jaipuria Hospital, Jaipur, Shri Ashwini Saxena ENT Hospital Rewari, AIIMS Bhubaneswar and SP Medical College Bikaner, in India to evaluate patients with acute salivary gland swellings. Clinical and laboratory data were collected, including demographics, presenting symptoms, history of vaccination, imaging findings, and treatment outcomes. Patients were followed for four weeks post-treatment to monitor for delayed complications. Among 53 patients, a bimodal age distribution was observed, with peaks in early adolescents and middle-aged individuals. Vaccination status was recorded based on recall. Fever and salivary gland swelling were predominant symptoms, with a significant proportion experiencing submandibular gland involvement. Elevated serum amylase and CRP levels correlated with disease severity and prolonged symptomatic resolution. Notably, cases of sensorineural hearing loss (SNHL) and airway complications emerged as significant concerns. The study highlights a shift in mumps demographics, with higher age groups affected and increased incidence of complications like SNHL and airway compromise. International trends also suggest periodic outbreaks and evolving clinical manifestations post-COVID-19 pandemic. Factors contributing to mumps resurgence include lack of vaccination or vaccine efficacy, population immunity, and seasonal variations. India appears to be facing a potential mumps outbreak, characterized by atypical features and increased risk of complications like SNHL and airway compromise. Serum amylase and CRP serve as valuable markers for disease severity. Early recognition and management of complications are crucial, emphasizing the importance of mumps immunization to mitigate the impact of the disease. ENT specialists should remain vigilant for emerging complications, particularly SNHL, advocating for comprehensive immunization strategies.

Prospective Study on the Effects of Marijuana Smoking on Lipase and Amylase Activities among Adult Nigerians

Marijuana consumption is prevalent among young adults in Nigeria, and its effects on various physiological systems are of growing concern. This study investigates the impact of marijuana use on digestive enzymes, specifically serum amylase and lipase, to understand its potential implications on digestive health. This cross-sectional study was conducted in 120 participants comprising of 60 marijuana smokers and 60 non-smokers. Sociodemographic and lifestyle data were collected through structured questionnaires. Serum amylase and lipase activity levels were measured by spectrophotometric method and compared between the two groups. Statistical analysis was performed to assess differences and correlations. The study revealed that marijuana smokers had significantly higher serum amylase and lipase activities compared to non-smokers. Lipase activity correlated positively (r=0.425, p=0.019) with duration of marijuana use. Amylase activity was higher among males than females (r=-0.40, p=0.028). No significant correlation was found between the quantity of marijuana consumed and enzyme activities. Chronic marijuana consumption was associated with increased serum amylase and lipase activities, indicating potential alterations in pancreatic function. These findings suggest that marijuana use may have adverse effects on digestive health, warranting further investigation into the long-term implications. It is recommended that healthcare providers monitor digestive enzyme activities in marijuana users to detect early signs of pancreatic dysfunction.

Особливості клінічної симптоматики та можливості ранньої діагностики гострого панкреатиту у вагітних

Traditional methods of diagnosing acute pancreatitis (AP) in pregnant women do not differ from diagnostic criteria in the non-pregnant population. Instead, physiological changes during pregnancy and the similarity of clinical manifestations of the disease with typical pregnancy complications are associated with difficulties in diagnosis, late diagnosis, and deterioration of treatment results. Аim - to analyze the diagnostic value of the criteria for diagnosing AP in pregnant women. Materials and methods. 123 pregnant women aged 18 to 42 years with a gestation period of 12 to 37 weeks (on average - 21.95±8.81 weeks) with AP were examined: I (control) group - 62 pregnant women, using traditional methods of treatment and diagnosis, and II (main) group - 61 pregnant women, using the developed diagnostic and treatment algorithm. Statistical data processing was carried out using the SPSS 21 program. Results. Our results show that the triad of clinical symptoms of AP (typical "pancreatic" pain, nausea and vomiting, paralytic intestinal obstruction) are found in only 29% of pregnant women. The frequency of painless forms of AP is 29.1%. The diagnostic sensitivity and specificity of blood leucocytosis for AP in pregnant women is 75.8% and 54.8%, an increase in the level of serum amylase 3 times about the upper limit of average - 74.2% and 68.7%, lipase - 77.4% and 90.3%, respectively. 48.4% of pregnant women had sonographic changes characteristic of AP within the first day from the moment of disease manifestation. In the group ІІ, when applying the diagnostic and treatment algorithm, 100% of patients had acute pancreatitis at an early stag Conclusions. Our results indicate that early diagnosis of AP in pregnant women using generally accepted diagnostic criteria is possible in no more than 48.8% of cases, which suggests the need to improve early diagnosis of the disease in this category of patients. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors.

Potential benefit of Lactobacillus acidophilus supplementation to rats fed with a high-fat diet on serum lipid profile, kidney amyloid protein and tumor necrosis factor-alpha level

AimIt was aimed to determine the potential effect of Lactobacillus acidophilus supplementation on rats exposed to an experimental high-fat diet on serum lipid profile and kidney total beta amyloid protein (TBAP) and Tumor Necrosis Factor-alpha (TNF-α) levels. Methods24 male Sprague-Dawley rats were used in the study to establish 4 groups. Standard rat food (SD) was provided to Group 1 as the control; Group 2 was fed a high-fat diet (HFD); Group 3 consumed SD and received L. acidophilus probiotics; Group 4 was fed HFD and received L. acidophilus probiotics. Body weights were determined weekly during the 12-week trial period. At the end of the experiment, TBP and TNF-α levels in the serum and kidney tissue of the rats were measured by ELISA method. Serum total cholesterol (TC), triglyceride (TG), HDL, LDL, urea and creatinine levels and paraoxanase, amylase and lipase activities were determined by spectrophotometric method on the analyzer device. ResultsWhen the control (Group 1) group and Group 2 were compared at the end of the experiment, it was found that Group 2 had gained the most weight and that both the blood and kidney tissue levels of TNF-α and TBAP, as well as the quantities of TG, TK, LDL, and urea, were significantly greater (P<0.05). Serum HDL, PON and amylase levels were found to be significantly low (P>0.05). TG, TK, LDL, urea, and the levels of TNF-α and TBAP in serum and renal tissue were shown to be lower in the groups who received L. acidophilus probiotics (Groups 3, 4) when compared to Group 2 (P>0.05). It was observed that HDL, PON and amylase levels increased and approached the control group (P<0.05). ConclusionThe study's findings showed that probiotic supplementation improved blood levels of TG, TC, HDL, LDL, urea, PON, and amylase as well as serum and kidney tissue levels of TNF-α and TBAP in obese rats fed a high-fat diet.

Oleuropein Relieves Pancreatic Ischemia Reperfusion Injury in Rats by Suppressing Inflammation and Oxidative Stress through HMGB1/NF-κB Pathway.

Oleuropein (OLP) is a naturally occurring phenolic compound in olive plant with antioxidant and anti-inflammatory potential and can possibly be used in treating pancreatic injuries. This investigation aimed to follow the molecular mechanism behind the potential therapeutic effect of OLP against pancreatic injury persuaded by ischemia-reperfusion (I/R). Pancreatic I/R injury was induced by splenic artery occlusion for 60 min followed by reperfusion. Oral administration of OLP (10 and 20 mg/kg) for 2 days significantly alleviated I/R-persuaded oxidative damage and inflammatory responses in pancreatic tissue as indicated by the decreased malondialdehyde (MDA) content and increased glutathione peroxidase (GPx) activity, accompanied by the suppression of myeloperoxidase (MPO) activity and reduced levels of interleukin-1beta (IL-1β), nuclear factor kappa B (NF-κB), and tumor necrosis factor alpha (TNF-α) in pancreatic tissues. Furthermore, OLP treatment markedly restored the serum levels of amylase, trypsinogen-activated peptide (TAP), and lipase, with concurrent improvement in pancreatic histopathological alterations. Moreover, treatment with OLP regulated the pancreatic expression of inducible nitric oxide synthase (iNOS) and high-mobility group box 1 (HMGB1) relative to rats of the pancreatic IR group. Thus, OLP treatment significantly alleviates the I/R-induced pancreatic injury by inhibiting oxidative stress and inflammation in rats through downregulation of HMGB1 and its downstream NF-κB signaling pathway.

Bufalin alleviates inflammatory response and oxidative stress in experimental severe acute pancreatitis through activating Keap1-Nrf2/HO-1 and inhibiting NF-κB pathways

Severe acute pancreatitis (SAP) is a prevalent acute inflammatory disease that is clinically manifested by systemic inflammation dysregulation, resulting in a significantly elevated mortality rate. Bufalin has been verified to have potent pharmacological properties, including analgesic, anti-tumor and anti-inflammatory effects. However, it remains unclear whether bufalin inhibits SAP. Thus, we aim to explore the impact of bufalin in SAP rats and to evaluate the potential mechanisms of action. In addition to analyzing serum biochemistry and pancreatic tissue pathology, we elucidated its mechanisms of action through enzyme-linked immunosorbent assay (ELISA), immunohistochemical analysis, Western blot, and quantitative real-time PCR. The results demonstrated that bufalin dose-dependently reversed the elevation of serum Amylase (Amy) and Lipase (LPS) levels in SAP rats, alleviating pancreatic tissue pathological damage. Bufalin exhibited potent antioxidant effects by reducing malondialdehyde (MDA) levels, decreasing Superoxide dismutase (SOD) and glutathione(GSH) consumption, inhibiting the interaction of Keap1-Nrf2, and increasing HO-1 expression. Furthermore, bufalin inhibited TNF-α, IL-6, IL-1β, p-NF-κB-p65, p-IκBα, and NF-κB-p65 expression, while enhancing IκBα expression, ultimately confirming its anti-inflammatory effects on SAP. In summary, our findings suggest that bufalin exerts anti-inflammatory and antioxidant actions in NaT-SAP rats by inhibiting NF-κB and activating the Keap1-Nrf2/HO-1 pathway. This study represents the inaugural application of bufalin in NaT-induced SAP rats, indicating its potential as an effective therapeutic agent for SAP patients.

INFLUENCE OF VITAMIN E ON PANCREATIC ACINAR CELL MORPHOLOGY AND SERUM AMYLASE CONCENTRATIONS IN ALCOHOL-INDUCED PANCREATIC TOXICITY.

Misusing alcohol can cause damage to different tissues in the body, resulting in conditions like alcoholic liver disease, pancreatitis, cardiomyopathy, neurotoxicity, muscle wasting, weakened immune system, hormonal disruptions, birth defects, and bone loss. The objective of this research was to evaluate how alcohol affects the exocrine pancreas histology and the levels of amylase in the blood serum. Additionally, it aimed to explore whether vitamin E provides a safeguard against alcohol-induced harm to the pancreas in rabbits. A laboratory-based experimental investigation was carried out at Peshawar Medical College involving eighteen healthy adult male domestic rabbits weighing between one to one and a half kilograms each. The rabbits were divided into three groups. Group A, serving as the control, received normal saline as a placebo. Group B was administered a daily dose of 30 percent ethanol solution (30 ml/kg/day) in normal saline. Group C received a daily oral dose of 30% ethanol solution (30 ml/kg/day) in normal saline along with vitamin E (50 mg/kg/day). Blood samples were collected for serum amylase analysis, while morphological assessment of acinar cells involved evaluating cell count, acinar size, acinar cell size, and acinar nucleus size. Serum amylase levels did not exhibit a statistically significant variance between the control and experimental groups as p-value was >0.05. Furthermore, no notable distinctions were noted in the size and number of pancreas acini, cells of pancreatic acini, and pancreatic acinar cells nuclei between the control and experimental groups in both category E4 and Category E8, as p >0.05. There were no significant variations noted in the size and number of acini in pancreas, cells in pancreatic acini, and nuclei of cells in pancreatic acini. Consequently, the protective role of vitamin E against alcohol-induced pancreatic damage was not conclusively identified.